EmblemHealth for Medicare Beneficiaries

Looking for a Formulary?

The 2018 Formulary request page is under development and will not be available until October 01, 2017. Please contact customer service at 1-877-344-7364 (TTY: 711), Monday through Sunday, from 8am to 8pm for further assistance.

We’re New Yorkers too. In fact, we have been bringing quality health care coverage to the New York community for over 75 years. We live here and work here just like you do, so we understand how complex health care can be –that’s why we’re here to help. Learn more about what makes us unique to New York and start getting the Medicare insurance benefits you deserve.

You've looked at your health insurance options, and now you’re ready to enroll. We want to make the process as easy as possible for you. This section outlines your three EmblemHealth Medicare Advantage Plan enrollment options.

There are also other ways to contact us. You can also contact Medicare directly about your health plan or prescription drug plan. Before you contact Medicare directly, we encourage you to call EmblemHealth Customer Service at the numbers listed above. EmblemHealth is responsible for resolving all of your issues related to your health plan and prescription drug plan coverage.

Disclaimers

HIP Health Plan of New York (HIP) is a HMO plan with a Medicare contract. Group
Health Incorporated (GHI) is a standalone PDP with a Medicare contract. Enrollment in
HIP and GHI depends on contract renewal. HIP and GHI are EmblemHealth companies.

All Medicare Advantage Plans and Medicare Prescription Drug Plans agree to stay in the program for a full calendar year at a time. Each year, plans can decide whether to continue to participate with Medicare Advantage or Medicare Prescription Drug Plans. A plan may continue in their entire service area (geographic area where the plan accepts members) or choose to continue only in certain areas. Also, Medicare may decide to end a contract with a plan. Even if your Medicare Advantage Plan or Prescription Drug Plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue for an additional calendar year, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare part B premium. Our Medicare Special Needs Plan is for people with both Medicare and Medicaid. Your eligibility to enroll in this plan may depend on your Medicaid status. Premium, copays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

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